This study reviews the authors' experience with 13 cases of brachial artery thrombosis following cardiac catheterization. Eleven patients underwent bra chial artery exploration with complete restoration of normal distal pulses and excellent long-term results. There was no morbidity or mortality. The 2 patients who did not undergo surgical repair complained of exercise-induced hand ische mia. The etiology of the thrombosis and alternatives in surgical management are discussed. An aggressive approach toward vascular injury associated with retrograde brachial artery catheterization is warranted.